Zarifa Abdel Khadr came in secret to Gaza City's jewellery souk this week to sell the two gold rings she has owned for half a century.

She had no intention of telling her five sons and four daughters that she was parting with her possessions for about £150 to help feed them and her grandchildren.

"They wouldn't allow me to do this if they knew," she said. "I'll buy flour, the basics and give it to them. I'll tell them God sent it to me. Of course the rings are dear to me, but my children and grandchildren have to eat."

Mrs Abdel Khadr, 78, said three of her sons were Palestinian Authority employees, among more than 150,000 in their third month without a salary because of Israel's decision to withhold $60m (£32m) a month in duties owed to the PA and the international community's cancellation of the PA's direct aid until Hamas fulfils conditions set for it.

She was far from alone in a gold market where the dealers were doing all the buying and the public all the selling. Yasser Mtar, 35, who runs a gold stall, said his purchasing volume had increased by 70 per cent since December last year. "It is a sign of how things are," he added. "What can they do? They have no choice."

That was certainly the view of Sabrin Turk, who, although only 17 years old, has already been married to a PA police officer for two years and has an infant son and daughter. She was hoping to get £150 for the gold ring and necklace that she had acquired as marriage dowry. "My husband was getting 1,500 shekels [£180] a month and now he isn't getting anything," she said. "This will help us pay back money we borrowed for furniture and to buy food."

Ms Turk's position will not change because of Tuesday's decision by the international Quartet in New York to approve emergency aid to a Palestinian economy in which, even before the current squeeze, more than 60 per cent of the population lived on less than $2.10 per day. For, as one of more than 70,000 members of the security services, her husband will not benefit from a fund directed at health and education.

The timetable for establishing such a fund - which one European diplomat said he hoped would take between one and two months but admitted could take more - is far less clear than the scale of the crisis it will attempt to alleviate. As Ishmail Haniya, the Hamas Palestinian Prime Minister, expressed suspicion of the plan, it was clear yesterday that many details were still to be agreed.

The scene at the market underlined that the Palestinian economy depends disproportionately on PA salaries. However, the cancer ward at Gaza's Shifa hospital is an equally potent illustration of another point repeatedly made by aid agencies: that they cannot possible replicate the essential services provided before the boycott.

Rima al Majdalawi, a mother of four, has metastatic ovarian cancer and needs chemotherapy. But there are no drugs for it at Shifa, any more than there are antibiotics for certain specific uses. Instead, the only treatment Ms Majdalawi, 28, is receiving is symptomatic. This includes paracetemol for fever and morphine for the pain, a drug which itself is in short supply and issued only when it is desperately needed. "We could run out of it any minute," Saleh al Dali, the hospital's haematology and oncology chief nursing officer, says.

Officials say four kidney patients have already died after their dialysis was reduced from three times to twice a day because of drug shortages.

"We have nothing to do with Fatah or Hamas," Ms Majdalawi's mother, Ataf, said. "But we are paying the price. We are always facing pressures but now they want the Palestinians to overturn their government."

Ms Majdalawi should have been seen by doctors in Israel's Tel Hashomer hospital recently, but was refused permission. "I am dangerous," she said. "I am a security risk."

But while security reasons are often cited for not allowing patients into Israel, Dr Basem Naim, the Palestinian Health Minister, said that many of the 270 patients awaiting visits to Israeli hospitals were unable to go because the PA simply did not have the money to pay for their treatment.

Whether the emergency measures pledged in New York will come soon enough or be wide-ranging enough for patients like Ms Majdalawi remains to be seen.

Tzipi Livni, the Israeli Foreign Minister, said for the first time last night that Israel might after all be prepared to release the monthly duties owed to the PA to the new fund - provided that they were for purely "humanitarian" and not for PA salaries.

In the shorter term,Israel's initial reaction to the latest blow to hit the Palestinians, the Israeli company Dor Energy's decision to cut off petrol supplies to the Palestinian fuel monopoly because of unpaid bills, was that it would not be using the funds to repay the fuel debt. But the pressure not to allow a full-scale Palestinian fuel crisis, Hamas or no Hamas, could yet prove irresistible.